COVID-19

1. The community’s administrator or designee will be responsible to establish requirements of visitors including establishing in advance expectations of the activities to be provided by the visitor.

2. Communities may determine the maximum number of visitors permitted in the facility at one time. Communities should carefully assess the risks of permitting a visitor and re-evaluate these as conditions change within the setting and the broader geographic area.

3. Facilities may consider scheduling of visitation. This should be clearly established in advance and appropriate to the community’s needs to manage visitors.

4. Communities should carefully consider the current status of COVID-19 both in their building and local geographic area prior to allowing visitors.  The community may temporarily suspend visitation if deemed necessary by the administrator or designee as established by the community’s program guidelines or state or federal guidelines.

5. If residents are cohorted by COVID-19 status, visitors will not be allowed in areas designated to care for COVID-19 individuals or areas designated to care for persons with unknown COVID-19 status.

6. Risk should be minimized by establishing clear plans for PPE use, including the type of PPE required, who is responsible for providing PPE, if the facility will furnish PPE to visitors (and if at any cost), instruction on proper use of PPE, COVID-19 screening, entry and exit procedures, locations where visitors may be present with tightly restricted movement through the facility, appropriate uses of indoor/outdoor spaces, and distancing policies with others in the community.

7. Communities may establish screening procedures for symptoms of COVID-19 before entering the setting, to include an elevated temperature, and may require a negative COVID-19 test prior to scheduling visits and any regular testing as deemed necessary. Visitors should be instructed to closely monitor their symptoms and not visit if experiencing any symptoms.

8. Communities should closely track the arrival and departure of visitors, to include names, addresses, email addresses, and time in/out for purposes of contact-tracing as required by state or federal guidelines or regulations.

9. Visitors should be provided with guidelines on the expectations of their role, to include making safe choices about personal contacts and activities outside of the home.

10.  Communications between the visitor and facility will be through any relevant forms of communication used by the community.

11. Any additional requirements within specialty care assisted living facilities must be clearly established and communicated to all visitors, staff, and any others present within these areas.

12. The facility may temporarily suspend or terminate visitor status for failure to comply with their agreement or the community’s guidelines.

13.  All facility staff should be made aware of the policies and guidelines for visitors and how they will be implemented and enforced.

In addition, each facility subject to this paragraph shall post in a conspicuous location at each public entrance a statement substantially similar to the following statement:

By order of the Governor of Alabama and the State Health Officer, each patient or resident of this facility enjoys certain rights to have one caregiver or one visitor present at a time, subject to reasonable restrictions. If you have questions, you may ask to inspect the facility’s written policies concerning visitation.

CMS guidelines as of 4/2/2020-
https://www.cms.gov/files/document/4220-covid-19-long-term-care-facility-gui
dance.pdf

CDC Guidelines – https://www.cdc.gov/coronavirus/2019-ncov/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2Findex.html

ADPH Info –
https://www.alabamapublichealth.gov/infectiousdiseases/2019-coronavirus.html

CDC Guidance on PPE and Infection Control

COVID19 REPORT CARD (Reporting)

To view the HealthCare Worker Liability Protection Proclamation from the Governor, click here.

Coronavirus Questions and Answers

A reminder from Dennis Blair, ADPH-
I want to remind everyone that facilities are responsible for reporting suspected COVID-19 to their local Health Department.  If a facility is suspicious enough to test, they need to report. Health Provider Standards would also appreciate a courtesy notification as well, cynthia.granger@adph.state.al.us or Mia.Sadler@adph.state.al.us

In regards to admitting residents, the facility would not be in violation of State Board of Health (SBOH) rules if it chose not to admit residents at this time. However, if a facility chooses to admit a resident, the resident must meet all admission criteria found in the rules including a statement from the physician that the resident is free from contagious or infectious disease. A problem I see with admitting a new resident is the coming and going of the resident’s family while moving the resident into the facility. These “visitors” would violate the state mandatory health order and the CDC guidelines that only essential healthcare personnel can visit the facility.

Regarding the coming and going of staff, the facility is responsible for screening employees for signs and symptoms of infection at the beginning of the employee’s shift. I have included the link to the CDC website that provides recommendations for screening and assessing staff.

https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/prevent-spread-in-long-term-care-facilities.html

ALFs and SCALFs are long term care facilities and should be following the guidelines and recommendations set forth by the ADPH and the CDC for protecting residents and staff from infection and spread of  COVID-19. I have included links to those websites.  In addition, you will also find a link to the state wide mandatory health orders issued by Dr. Harris, State Health Officer. Please be sure to review those orders.

https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/prevent-spread-in-long-term-care-facilities.html

http://www.alabamapublichealth.gov/

http://alabamapublichealth.gov/news/2020/index.html

QUESTION:
How does it work when we have a resident in the hospital or at rehab and they are ready for discharge? We have one who is in rehab now and they are wanting to discharge her.

RESPONSE:
Residents should be thoroughly assessed for eligibility to return to the facility.  The facility should ensure the resident has been cleared by the physician to be free of signs and symptoms of contagious and/or infectious disease. The facility should conduct its own screening for signs and symptoms of infection upon re-entry into the building and continue diligent health observation of the resident.

QUESTION:
What is appropriate dining in an Assisted Living. If a resident(s) prefer to dine in the communal dining area, their request is documented to include their understanding of the risks involved, this action is care planned, social distancing is maintained, would this be allowed?

RESPONSE:
The facility is responsible for following guidelines put in place by the ADPH and the CDC. If the dining room can be arranged to meet the required social distancing and the number of residents gathering, I don’t see a problem. Currently social distancing is 4-6 feet from one person to another, that would mean not sitting side by side at a table with other residents, and less than 25 people gathered in the same area. Keep in mind these numbers can and probably will change, I know the President was talking about a gathering of 10 or less people.

I understand these are difficult times for staff and residents but it is the facility’s responsibility to do what they need to do to protect residents from infection.

EMPLOYER INSIGHTS INTO THE FAMILIES FIRST CORONAVIRUS RESPONSE ACT (“FFCRA”)

On March 18, 2020 President Trump signed the Families First Coronavirus Response Act (“FFCRA”) to provide relief to employees from economic issues stemming from the COVID-19 pandemic.  In our effort to keep ALAA members informed, we would suggest that you visit LYONS HR at:  WWW.LYONSHR.COM. LYONS HR is an Associate Member of ALAA and we consider LYONS HR a subject matter expert when it comes to employment matters, human resources management, and workplace regulatory compliance assistance.  For those of you who do not have a full-service HR departments, and need help in navigating the many concerns relating to COVID-19, you may contact Alan Ridgway and he will be available to offer assistance and guidance as needed to address your concerns.  You can reach Alan at:

Alan Ridgway                                  
Sr. Vice President
Business Development
Lyons HR
Office: (256) 546-9493 Ext. #601
Cell:    (205) 914-8412